One year mortality following surgical intervention for neck of femur fractures in the elderly in a developing country.
Pieterse, Barend Hermanus
BACKGROUND: Fractures of the neck of the femur are currently one of the most serious health care problems facing developed nations on account of their aging populations. The one-year mortality rate is in the region of 30%. Although less of burden in developing nations, the fractures still affect a significant proportion of the elderly population. Very little has been published on the subject in developing nations and outcomes in resource rich countries may not be applicable to the less developed world. We hypothesized that the one year mortality would be higher in our setting. AIM OF THE STUDY: To determine the one year mortality following operative treatment of neck of femur fractures in the elderly at Charlotte-Maxeke Johannesburg academic hospital. METHODS: We undertook a retrospective study of all patients admitted with a fractured neck of femur in a teaching hospital over a five year period. Males and females over the age of 65 who underwent surgical treatment for neck of femur fractures where included into the study. Excluded was open fractures of any nature, neck of femur fractures due to tumors or metastatic bone disease, hip fractures other than neck of femur fractures and hip fractures treated nonoperatively. The patient’s files were collected to identify their ID numbers. Home affairs records was used to determine if the ID numbers were registered as a death. The website http://www.dha.gov.za/status was used for this purpose. To determine the time of death of the deceased patients Home affairs was contacted using the Request for access to record of public body form. RESULTS: The study comprised of 66.2% females and 33.8% males with a age range of 65-93 and a mean age of 80. We found that females had a higher age at the time of surgery than males. Our one year mortality was 43% (p=0.00288781) and significance level of 99.7%. CONCLUSION: Our mortality rate was significant higher compared to international or local figures. This might be due to the higher age of patients that we are seeing or lack of proper treatment protocols for the elderly with neck of femur fractures. Further investigations are needed to determine the cause.
Research report submitted in partial fulfillment of requirements for Master of medicine in orthopaedic surgery (mmed orth) at the University of Witwatersrand, Johannesburg
Pieterse, B. H. One year mortality following surgical intervention for neck of femur fractures in the elderly in a developing country. Johannesburg: University Of Witwatersrand. 2017